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Abstract

Introduction: Short stature is a risk factor for transradial access failure and radial artery spasm. However, it is unclear if height is related to bleeding complications post transradial versus transfemoral PCI.

Methods: We analyzed 3913 primary PCIs performed at our institution between 2011 and 2014, identifying factors associated with bleeding complications up to 72 hours post-PCI or prior to patient discharge. Bleeding was defined using the CathPCI NCDR registry standards including any decline in hemoglobin >3g/dl, blood transfusion, or need for vascular injury repair. We performed Chi-square testing and radial/femoral adjusted regression modelling with bleeding as exposure for our primary analysis.

Results: Bleeding occurred in 1.9% of the total study population (76 out of 3913 primary PCIs) with statistically significant differences in rates between radial and femoral approaches (1.2% vs 5.4%, p<0.01). All patients in our cohort had lower rates of bleeding with increasing height on adjusted regression modelling (Figure 1) (95% CI [-0.06, -0.01], p<0.01). Weight, body surface area and dosing weight (DW) were lower in patients with bleeding in the transfemoral group (p<0.015, <0.007 and <0.01 respectively). For the transradial approach increased bleeding was noted with shorter stature and lower ideal body weight (p<0.02 and <0.026 respectively) (Figure 2).

Conclusion: Our study shows that short stature is a predictor of post-PCI bleeding in transradial PCIs but not with the transfemoral PCIs. This indicates that patients with short stature require aggressive management strategies to reduce bleeding risk especially in the era of increasing transradial procedures.